Change in behavior

@mgould

Consulted AI? Yikes.

Perhaps you should consider a specialist for medication management. A geriatric psychiatrist would be best, but a knowledgeable neurologist would be great as well.

Rexalti does work well for those who can qualify (usually EO patients on commercial insurance with a coupon), but so do a host of other atypical antipsychotics from the same class that are available as generics. Dad did really well on generic Seroqel and I know others who did well on generic forms of Risperdal and Abilify.

Rexalti is newer and does have dementia with agitation as an indication because the manufacturer did the studies. While the older meds never went through studies to qualify for that indication, they have been safely used off-label for years and years. FWIW, all antipsychotics carry the same Black Box Warning.

HB

The Black Box Warning is universal among the atypical antipsychotic class of medications.

Deciding on medication becomes an exercise in risk/benefit ratios. On one hand, these are powerful psychoactive medications, albeit prescribed in much lower doses for dementia agitation than for either bipolar disorder or schizophrenia. On the other, behavior is communication. PWD often have anxiety and damage to parts of the brain that results in disordered behavior that isn't responsive to behavior modification or other medications. A person with dementia is terminally ill; at a certain point, quality of life can be more important that quantity.

HB